Trump’s Medicaid cuts threaten access for thousands in key swing state

A nurse tending to a patient in 2024

Since Medicaid was expanded by the North Carolina State Legislature in early 2024, around 650,000 residents of the swing state signed up for it. But now, according to Washington Post reporter Paige Winfield Cunningham, they are in danger of losing that coverage thanks to draconian Medicaid cuts in President Donald Trump's "big, beautiful bill" — which he signed into law over the 4th of July Weekend after it was passed by GOP majorities in both houses of Congress.

In an article published on August 18, Cunningham explains, "In signing that law, Trump approved more than $900 billion in cuts to Medicaid over the next decade. Those cuts are colliding with state budget challenges, imperiling the future of Medicaid in states such as North Carolina.

In a letter sent on August 11, Devdutta Sangvai — secretary of the North Carolina Department of Health and Human Services (NCDHHS) — told members of the state legislature that the department will begin slashing Medicaid payments to doctors and hospitals on October 1.

Sangvai wrote, "To meet an effective date of October 1, we must begin several administrative steps now, including notifying providers and beneficiaries, updating contracts and systems, and informing our federal partners at the Centers for Medicare and Medicaid Services (CMS). We have attempted to make these cuts reversible in the event that additional funding is approved. Absent additional appropriations by the General Assembly, however, NCDHHS will proceed with the reductions described herein."

Cunningham notes that "cuts to Medicaid affect more North Carolinians than ever before."

"The state's Medicaid rolls swelled nearly 30 percent, to 3 million people, after state Republicans dropped their decade-long opposition to expanding the program under the increasingly popular Affordable Care Act and worked with Democrats to broaden eligibility," the Washington Post journalist reports. "Before that expansion, Medicaid mainly covered people with low incomes who were disabled, had dependent children or were pregnant. But now, in most states, just about anyone earning up to 138 percent of the federal poverty threshold — $22,000 for a single person and $44,000 for a family of four — is eligible."

Cunningham adds, "Previously, these low-income earners had fallen through the cracks of a patchwork insurance system. Many had no employer-sponsored coverage and didn't earn enough to qualify for subsidized plans sold on Affordable Care Act marketplaces. But under Trump's new law, millions of Americans are projected to drop out of Medicaid under stricter rules to qualify for the insurance and stay enrolled. That in turn will result in states receiving fewer Medicaid dollars from the federal government, which covers about two-thirds of the costs."

Cunningham points to North Carolina resident Sonya Poole, a 64-year-old cancer survivor, as an example of someone who signed up for Medicaid but is in danger of losing her access to health care.

"Poole will become eligible for Medicare next year before the new Medicaid changes kick in," Cunningham notes. "But she's the kind of patient experts worry could lose Medicaid coverage if they fail to turn in the extra paperwork that might be required for them to stay on the program."

Read Paige Winfield Cunningham's full Washington Post article at this link (subscription required).